摘要
背景:炎症性肠病(IBD)具有慢性和反复发作的特点,肠壁组织反复损伤和修复可致局部纤维化和瘢痕形成。目的:观察IBD患者常用血清纤维化指标层黏蛋白(LN)、Ⅳ型胶原(C-Ⅳ)、透明质酸(HA)和Ⅲ型前胶原氨基端肽(PⅢNP)的变化,评价其与疾病活动度的关系。方法:收集经结肠镜和活检病理检查确诊的48例溃疡性结肠炎(UC)患者、50例克罗恩病(CD)患者和50例对照者,以放射免疫测定检测血清LN、C-Ⅳ、HA和PⅢNP水平,以酶联免疫吸附测定(ELISA)检测血清高敏C反应蛋白(hs-CRP)水平。结果:与对照组相比,UC和CD患者血清LN水平显著增高,C-Ⅳ和PⅢNP水平显著降低(P<0.05),UC和CD两组间则无明显差异;三组间血清HA水平均无明显差异。血清hs-CRP水平可反映IBD疾病活动度,活动期患者hs-CRP水平均高于200mg/L。IBD患者的LN水平与hs-CRP呈正相关(UC:r=0.33,CD:r=0.53.P<0.05),C-Ⅳ和PⅢNP水平与hs-CRP无明显关联。LN水平与CD病变部位无明显关联。结论:IBD患者血清LN水平增高,C-Ⅳ和PⅢNP水平降低,可能成为肠壁组织炎症和修复的间接标志物:血清LN水平可间接反映IBD疾病活动度。
Background： Chronic and recurrent inflammation is the main characteristic of inflammatory bowel disease （IBD）, and repeated injury and repair of the intestinal wall may result in local fibrosis and scar formation. Aims： To study the alterations of commonly used serumfibrotic markers, laminin （LN）, collagen Ⅳ （C-Ⅳ）, hyaluronic acid （HA） and procollagen m N-terminal peptide （PmNP） in IBD patients and the correlations between these markers and the activity of disease. Methods： Forty-eight ulcerative colitis （UC）, 50 Crohn＇s disease （CD） diagnosed by colonoscopy and biopsy pathology and 50 matched controls were recruited in this study. The serum levels of LN, C-Ⅳ, HA and PmNP were measured by radioimmunoassay, and serum level of high-sensitivity C-reactive protein （hs-CRP） by enzyme-linked immunosorbent assay （ELISA）. Results： In UC and CD patients, the serum level of LN was significantly higher and the serum levels of C-Ⅳ and pIIlNP were signifieandy lower than those in the controls （P〈0.05）, while the serum level of HA was not different from that in the controls. No difference was found between UC and CD patients for all these markers. Serum level of hs-CRP could reflect the disease activity of IBD, and the serum level of hs-CRP in active patients were higher than 200 mg/L. There was a positive correlation between serum levels of LN and hs-CRP in IBD patients （UC： r= 0.33, CD： r=0.53, P〈0.05）, but not between C-Ⅳ and hs-CPR as well as Pm NP and hs-CRP. No association was found between serum LN level and disease location in CD. Conclusions： The increased serum level of LN as well as decreased serum levels of C-Ⅳ and P m NP may be used as indirect markers for sustained intestinal wall inflammation and tissue repairing in IBD patients. Serum level of LN may reflect the disease activity of IBD indirectly.
出处
《胃肠病学》
2007年第10期623-625,共3页
Chinese Journal of Gastroenterology
关键词
炎性肠疾病
层黏连蛋白
胶原Ⅳ型
透明质酸
前胶原
C反应蛋白
Inflammatory Bowel Diseases
Laminin
Collagen Type Ⅳ
Hyaluronic Acid
Procollagen
C-Reactive Protein
